CARLOS A IBANEZ MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****45

NOT RENEWED

N

CARLOS A

IBANEZ

MD

CARLOS A IBANEZ MD

09/24/1981

09/24/1981

07/31/1984

CHICAGO

IL

60613

COOK

II III IV V

N

09/26/2006